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NOTICE:
CUSTOMER PRIVACY
Date: April 1, 2003
We are
committed to preserving the privacy of your personal health
information. In fact, we are required by law to protect the
privacy of your medical information and provide you with Notice
describing:
HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN ACCESS THIS INFORMATION.
We are required by law to have your written consent before
we use or disclose to others your medical information for
purposes or providing or arranging for your health care, the
payment for or reimbursement of the care that we provide to
you, and the related administrative activities supporting
your treatment.
We may
be required or permitted by certain laws to use and disclose
your medical information for other purposes without your consent
or authorization.
As our
customer, you have important rights relating to inspecting
and copying your medical information that we maintain, amending
or correcting that information. Obtaining and accounting of
our disclosures of your medical information, requesting that
we restrict certain uses and disclosures of your health information,
and complaining if you think your rights have been violated.
We have
available a detailed Notice of Privacy Practices which fully
explains your rights and our obligations under the law. We
may revise our Notice from time to time. The effective date
at the top right hand side of this page indicates the date
of the most current Notice in effect.
You have
the right to receive a copy of our most current Notice in
effect. If you have not yet reserved a copy of our current
Notice, please ask at the front desk and we will provide you
with a copy.
If you
have any questions, concerns or complaints about the Notice
of your medical information, please contact Donajane Lapinski
of our office at 734-422-4234.
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